Exercise during breast cancer chemotherapy: A telehealth pilot feasibility study

A multidisciplinary exercise induction program delivered by telehealth, to improve exercise, self-efficacy and quality of life in breast cancer patients undergoing chemotherapy. The program aims to assist participants to meet the Clinical Oncology Society of Australia guidelines for exercise which involve at least 150 minutes of moderate intensity aerobic exercise per week in addition to two to three resistance exercise sessions per week. There will be bi-weekly, virtual exercise classes across a 12 week period delivered through Microsoft Teams which will be supervised by a physiotherapist. Classes will commence once three participants have been recruited and the maximum group size will be five participants at any one time. The exercises completed during the classes will be individualized according to each patient depending on their baseline fitness and comorbidities during an initial physiotherapy assessment and will be based off the exercises recommended in the Cancer Council booklet, 'Exercise for People Living with Cancer'. Each exercise class will be 45 minutes in duration and will consist of a warm up and warm down component and a combination of the aerobic exercises prescribed, examples include jumping jacks and brisk walking on the spot and strength based exercises prescribed, examples of these include, bird-dog, pelvic tilt and bicep curl with dumbells. Attendance will be measured through a session attendance checklist and reason for absence will also be documented. In addition, to meet the 150 minutes of exercise recommended by COSA, participants will be encouraged to complete a daily exercise routine in their own time at home and record the type and quantity of exercise, either in a paper-based logbook or via the Physitrack app, for the duration of the study. This home exercise will consist of the same types of resistance and aerobic exercise completed in the bi-weekly classes. There will be also fortnightly, virtual educational classes to supplement the exercise classes, six in total, each delivered by a clinical member of a multidisciplinary team through Microsoft Teams. These educational sessions will discuss topics that are pertinent to cancer. Three sessions will be delivered by the clinical psychologist, one will be talk about mindfulness, the other session will be a talk about body image and another session will be a talk about anxiety education and management. There will be one session delivered by a dietician who will present a talk about nutrition during cancer treatment. There will be one session delivered by an occupational therapist who will present a talk about fatigue management. There will be one session delivered by a physiotherapist who will present a talk about maintaining physical activity. There will be informational materials provided from the Cancer Council website. These sessions will last for approximately 1 hour, including 15 minutes dedicated to a Q&A component. Attendance will be measured through a session attendance checklist and reason for absence will also be documented. After these 12 weeks of exercise and educational classes, there will be tapered phone calls by the research assistant to encourage maintenance of exercise levels and continual recording of daily exercise via the logbook/Physitrack app and to communicate back with the study physiotherapist if modifications need to be made to the exercise program. These phone calls will span a 12 week period and will begin at one phone call a week for four weeks, then one phone call once a month for two months. There will be six phone calls in total.